CDCAN REPORT #022-2011: Multipurpose Senior Services Program heard by Assembly Budget Subcommittee

• Assembly Budget Subcommittee Hears Governor’s Proposal to Eliminate Multipurpose Senior Services Program (MSSP) – Advocates Plead For Legislature to Reject Proposal
• Assembly Budget Subcommittee Hears From Dozens of Advocates for An Hour – Holds Item “Open” For Later Action Probably in Mid-February – Also Hears But Takes No Action Yet on Proposal for On-going Full Funding for Long Term Care Ombudsman – 46 Page Agenda for Senate Budget Subcommittee Hearing Jan 26th on Medi-Cal and Healthy Families Attached to This Report

SACRAMENTO, CALIF  (CDCAN) [Updated 01/25/2011  02:25 PM  (Pacific Time)] –   The first of Governor Jerry Brown’s sweeping health and human services permanent budget reduction proposals were heard today by the Assembly Budget Subcommittee on Health and Human Services, chaired by Assemblymember Holly Mitchell (Democrat – Los Angeles) [photo left], including the Governor’s proposal to eliminate completely the Multipurpose Senior Services Program (MSSP) that serves over 11,000 Medi-Cal eligible seniors over the age of 65 through 41 sites throughout the State.  Those seniors who participate in the program are those individuals who are certified or could be certified for placement in a health facility or other institution, but wanted to live in their own home.

Governor Brown’s proposal would eliminate the Multipurpose Senior Services Program, resulting in a reduction in State general fund spending (or savings to the  State general fund) of $19.9 million in the 2011-2012 State Budget year that begins July 1, 2011.

Governor Arnold Schwarzenegger proposed to eliminate funding for the MSSP in previous budget years, including last year, which the Legislature rejected.

MSSP Program Medicaid Program Overseen by Department of Aging

• The MSSP Program was established under the Medicaid Home and Community Based Services waiver program (a waiver waives or exempts the State from certain federal Medicaid rules in order to test or try out a project or program that Medicad rules would otherwise prohibit). 
• The Department of Aging administers the MSSP program statewide in partnership with the Department of Health Care Services, which is the lead state agency that oversees the State’s Medicaid program (called “Medi-Cal” in California). 
• The program provides social and health care case management services for eligible seniors, with the goal of the program to use community-based services and resources to prevent or delay placement in a health facilty or other institutional setting.

46 Page Agenda For Critically Important Senate Subcommittee Hearing on Medi-Cal and Healthy Families Attached

Meanwhile, another critical issue is scheduled for hearing Wednesday morning by the Senate Budget Subcommittee #3 on Health and Human Services focusing on the Governor’s proposed major cuts to Medi-Cal and Healthy Families.

Attached to this CDCAN Report (and available on the CDCAN website at www.cdcan.us) is the 46 page (pdf) Senate Budget Subcommittee on Health and Human Services 1/26th hearing agenda titled “2011-01-26 - Senate Budget Sub3 - Health (Medi-Cal Healthy Families).pdf” prepared by Senate Budget and Fiscal Review Committee consultant Diane Van Maren.  See below for more details about this important hearing and other hearings this week.

MSSP Proposal Part of $12.5 Billion In Permanent Cuts Proposed by Brown

• Governor Brown proposed on January 10th, $12.5 billion in permanent reductions in State general fund spending – including some fund shifts – but the bulk outright reductions in spending, including proposed elimination of the MSSP program, Adult Day Health Centers, cuts to the SSI/SSP (Supplemental Security Income/State Supplemental Payment) individual grants to the lowest amount allowed by the federal government, major cuts to the Healthy Families program matched by funds from the federal State Children’s Health Insurance Program (SCHIP).
• Other reductions to health and human services proposed by Governor Brown also include over $500 million in reductions in State general funding for In-Home Supportive Services (IHSS), over $750 million in cuts in State general funding for developmental services (the bulk of that cut hitting the 21 non-profit regional centers who coordinate services for over 240,000 children and adults with developmental disabilities), over $1.7 billion in reductions in State general fund money for the Medi-Cal program, over $1.5 billion in cuts in State general funding for the CalWORKS program.  Those proposals will be heard by the Assembly and Senate budget subcommittee this week and in the coming weeks (see CDCAN Reports for details)

What The Assembly Budget Subcommittee Decided Today

• For just about an hour, (until about 2 PM) the subcommittee heard from dozens of advocates, including several MSSP site directors, case managers, advocates from senior and other advocacy groups, and family members plead that the Legislature reject the Governor’s proposal to eliminate all funding for the program.  As of 4:30 PM, the subcommittee is still meeting, hearing its final agenda item (Emergency Medical Services Authority). 
• Many cited the vulnerability of this senior population, including cost shifting to emergency rooms or institutional care versus living in their own homes; potential violations of federal laws and the landmark 1999 US Supreme Court Olmstead v. Lois Curtis and Elaine Wilson lawsuit under the federal Americans with Disabilities Act (ADA) that required the states to take steps to avoid the unnecessary or unjustified institutionalization of persons with disabilities and seniors.  Others mentioned that the State had a responsibility to  protect and to provide these services to its seniors. 
• Assemblymember Mariko Yamada (Democrat – Davis), who chairs the Assembly Aging and Long Term Care Committee but is not a member of the Assembly Budget Subcommittee #1 on Health and Human Services, sat in on the entire subcommittee hearing.  The MSSP issue and other community-based programs serving seniors have been subjects of bills and informational hearings by Yamada’s committee.
• The subcommittee also heard briefly a proposal from the Brown Administration by the California Department on Aging for a way to fully fund the Long Term Care Ombudsman using funding from the existing skilled nursing facility State’s Penalty Citation Account and another similar account established by the nursing home quality assurance fee – referred to as AB 1629 quality assurance fee – that was reauthorized last year.  
• The ombudsman funding proposal was supported by the Area Agencies on Aging and other senior advocacy groups.  Two years ago Governor Schwarzenegger eliminated a major part of the funding for the ombudsman program.  The Legislature put in place last year temporary funding that almost fully funded the ombudsman program.  The proposal heard today would put in place a permanent on-going funding stream – but would still be subject to Legislative approval as part of the budget process. 
• Also heard various other budget items on the agenda, including Governor’s proposal to increase cost sharing for the AIDS Drug Assistance Program (ADAP).
• All five subcommittee members – plus Yamada – were present for the hearing today. 

SUBCOMMITTEE ACTION:

• The subcommittee after hearing the budget issue  on MSSP, and later, on the Long Term Care Ombudsman funding proposal, took no vote or action, holding both items “open”, meaning the subcommittee will take action on the proposal later – probably at the end of the subcommittee hearings in mid-February.
• Subcommittee heard brief overview of the Department of Rehabilitation from director Tony Sauer and a brief presentation of two non-controversial “budget change” proposals dealing with electronic records system and the Department of Rehabilitation and Department of Mental Health partnership agreement. The subcommittee approved by proposals. 
• The subcommittee also took action on several “budget change proposals” on dealing with other items on subcommittee agenda.

Assembly Budget Subcommittee Members

Total Members: 5
Democratic Members:  Wes Chesbro, Holly Mitchell (Chair), and Bill Monning
Republican Members:  Kevin Jefferies, and Allan Mansoor

Senate Budget Subcommittee Will Hear MSSP Proposal Feb 3

• The Senate Budget Subcommittee #3 on Health and Human Services is scheduled to hear the Governor’s MSSP proposal on February 3, 2011, Thursday, upon adjournment of the Senate Floor Session (sometime after 9:30 AM), at the State Capitol in Room 4203. 
• The hearing will be televised live on CalChannel (check local cable listings) and webcasted live from the CalChannel website at www.calchannel.com
• Other items on the hearing agenda include the Governor’s spending reduction proposals under the Department of Social Services impacting In-Home Supportive Services and SSI/SSP (Supplemental Security Income/State Supplemental Payment) grants
• Senate Budget subcommittee staff is estimating that the length of this hearing will be about 4 hours.

IMPORTANT BUDGET SUBCOMMITTEE HEARINGS THIS WEEK

Several budget subcommittee hearings scheduled for the remainder of this week including Senate Budget Subcommittee hearing on the Governor’s proposed major cuts to Medi-Cal on Wednesday (January 26th) at 10:00 AM; Governor’s proposed cuts to In-Home Supportive Services, SSI/SSP and the shift to the counties (realignment) of Adult Protective Services, before the Assembly Budget Subcommittee on Health & Human Services on Thursday, January 27th.

JANUARY 26, 2011 - WEDNESDAY

SENATE BUDGET SUBCOMMITTEE #3 ON HEALTH AND HUMAN SERVICES
10:00 AM or upon Adjournment of Senate Floor Session – State Capitol – Room 4203
Budget Items To Be Heard:

1. Emergency Medical Services Authority (Budget Item 4120) - Emergency System Registration of Volunteers
2. Department of Health Care Services (Budget Item 4260) - State Support, and Medi-Cal Program, including fund redirections
3. Managed Risk Medical Insurance Board (Budget Item 4280) - Healthy Families Program, Pre-Existing Condition Insurance Program (PCIP)

AGENDA:  Attached to this CDCAN Report 

CDCAN COMMENT:  Budget subcommittee staff estimates that this hearing will be about 4 hours in length depending on questions from members and testimony from public.  Governor is proposing over $1.7 billion in cuts to the Medi-Cal program and major cuts to the Healthy Families program.  The Assembly Budget Subcommittee #1 on Health and Human Services is hearing these issues on February 1.

CDCAN ACTION ALERT:  YES
PRIORITY: VERY HIGH

JANUARY 26, 2011 - WEDNESDAY

ASSEMBLY BUDGET SUBCOMMITTEE #2 EDUCATION FINANCE
10:00 AM – State Capitol – Room 444
Informational Hearing – Subject: Higher Education Overview
Budget Items To Be Heard:

• California State Library (Budget Item 6120)
• California Postsecondary Education Commission (Budget Item 6420)
• University of California(Budget Item 6440)
• Hastings College of the Law (Budget Item 6600)
• California State University(Budget Item 6610)
• ***Board of Governors: California Community Colleges (Budget Item 6870)
• California Student Aid Commission (Budget Item 7980)

Governor’s Budget Proposals – 2011-2012 State Budget:

• Department of Finance Presentation of Governor’s Higher Education Proposal
• Legislative Analyst Office: Assessment of Governor’s Proposals & Recommendations
• Higher Education Segments’ Response
• Public Comment

CDCAN COMMENT: Governor is proposing major cuts to higher education  - some, especially to community colleges – that would have major impact to students with disabilities, mental health needs, the blind, low income families
PRIORITY: HIGH

JANUARY 26, 2011 - WEDNESDAY

JOINT HEARING: ASSEMBLY BUDGET SUBCOMMITTEE #1 ON HEALTH AND HUMAN SERVICES AND ASSEMBLY BUDGET SUBCOMMITTEE #2 ON EDUCATION FINANCE
1:00 PM – State Capitol – Room 4202
Budget Items To Be Heard:

• ***Department of Mental Health (Budget Item 4440)
• ***Department of Education – Issue: AB 3632 special education mental health services mandate proposal

Upon Adjournment of the Joint Hearing – continuation of Budget items To Be Heard:

• ***Department of Mental Health (Budget item 4440)
• Department of Alcohol and Drug Programs

CDCAN COMMENT: Governor is proposing nearly $900 million shift of funds from Proposition 63 Mental Health Services Act fund balance to pay for 3 mental health programs currently funded by State general fund money: Medi-Cal mental health managed care services; AB 3632 special education mental health services mandate and Early, Periodic, Screening, Diagnosis Treatment (EPSDT) program during the 2011-2012 State Budget year.  Governor proposes funding those three programs in the 2012-2012 State Budget year by a dedicated funding source and replacing the money taken from Proposition 63.
CDCAN ACTION ALERT:  YES
PRIORITY: VERY HIGH

JANUARY 27, 2011 - THURSDAY

SENATE BUDGET SUBCOMMITTEE #3 ON HEALTH AND HUMAN SERVICES
09:30 AM or Upon Adjournment of Senate Floor Session – State Capitol – Room 4203
Budget Items To Be Heard:

• ***Department of Social Services (Budget Item 5180) – CalWORKS Program, CalFresh and Office of Systems Integration

CDCAN COMMENT:  Budget subcommittee staff is estimating that the length of this hearing will be about 4 hours.  Governor is proposing over $1.5 billion reductions in State general fund spending to the CalWORKS program – the State’s “welfare to work” program, including a narrowing of eligibility 13% reduction in the maximum grants. The Assembly Budget Subcommittee is holding its hearing on these issues on February 2.
PRIORITY: VERY HIGH

JANUARY 27, 2011 - THURSDAY

ASSEMBLY BUDGET SUBCOMMITTEE #1 ON HEALTH AND HUMAN SERVICES
1:00 PM – State Capitol – Room 4202
Budget Items To Be Heard:

Department of Social Services (Budget Item 5180)

• ***Child Welfare Services
• ***Foster Care
• ***In–Home Supportive Services
• ***SSI/SSP
• ***Adult Protective Services

CDCAN COMMENT: The Senate Budget Subcommittee  on Health and Human Services is hearing the IHSS and SSI/SSP budget issues on February 3rd.  The Governor is proposing over $500 million cut in State general fund spending to the IHSS program including additional 8.4% permanent across the board cut in hours for all persons receiving IHSS (on top of existing 3.6% cut that is due to go into effect February 1, 2011);  doctor’s certification that person applying for IHSS or already in the program is “at risk” of being institutionalized as a new eligibility requirement for the program; elimination of domestic and related services for children under age of 18 who live at home and for persons living in a “shared living arrangement”.   Governor proposing elimination of state funding for IHSS Advisory Committees.  Governor also proposing cutting SSI/SSP (and presumably Cash Assistance Program for Immigrants grants) to lowest level allowed by federal government (from $845 per month to $830 per month). Governor is proposing to shift State responsibility of adult protective services to the counties. 

CDCAN ACTION ALERT:  YES.  A rally – organized by the United Domestic Workers (UDW) is planned at the State Capitol North Steps (facing L Street) from 10:00 AM to 5 PM.  See separate CDCAN Action Alert and Report on this event. 

PRIORITY: VERY HIGH

File Attachments: 

2011-01-26 - Senate Budget Sub 3 - Health (Medi-Cal, Healthy Families).pdf